Deployable jaws retraction device

ABSTRACT

A deployable jaws retraction device is provided for retracting a body organ away from an operative site without occupying an incision or surgical access port during the surgical procedure. The deployable jaws retraction device includes a jaw assembly having two or more jaws joined at one end and a retention device to maintain the jaws of the closed condition about a target body organ. The deployable jaws retraction device additionally includes an anchoring assembly for securing the jaw assembly and body organ away from the operative site during the surgical procedure. The anchoring assembly includes a needle having a tissue penetrating tip and a length of suture material connecting the needle to the jaw assembly. There is also provided an applicator instrument for applying the deployable jaws retraction device onto a target body organ.

CROSS REFERENCE TO RELATED APPLICATIONS

The present application is a continuation application of U.S. patentapplication Ser. No. 12/791,012 filed on Jun. 1, 2010, which claims thebenefit of and priority to U.S. Provisional Application Ser. No.61/233,618 filed on Aug. 13, 2009, the entire contents of which areincorporated herein by reference

BACKGROUND

1. Technical Field

The present disclosure relates to a deployable jaws retraction device.More particularly, the present disclosure relates to a retraction devicefor engaging and retracting an organ within a body cavity and anapplicator instrument for positioning the retraction device about theorgan.

2. Background of Related Art

Many surgical procedures are currently performed in a minimally invasivemanner so as to limit the amount of trauma to the patient and promotemore rapid healing. These minimally invasive procedures generallyinclude forming one or more incisions through the body wall of a patientand inserting the operative surgical instruments through the incisions.In some instances, access ports are inserted through the incisions andare provided to receive surgical instruments therethrough. In somesurgical procedures, it is often necessary to move or retract a portionof the body, such as a body organ, away from the operative site tofacilitate performing the surgery. This is often accomplished byinserting an elongate retraction instrument through the incision oraccess port and utilizing movable jaw structure located at a distal endof the surgical instrument to grasp the body organ and move or retractthe body organ away from the operative site.

In these methods of retracting body organs, the elongate retractioninstrument remains positioned through the body wall and occupies theincision or access port during the entire surgical procedure. In complexsurgical procedures, multiple incisions or access ports are required toaccommodate the multiple surgical instruments used during the surgicalprocedures. Each incision or access port utilized in the surgicalprocedure contributes to the degree of trauma and rate of healing of thepatient.

Therefore, it is desirable to provide retraction device assemblyincluding an applicator instrument and a deployable retraction devicewhich can be inserted through a surgical incision or access port toengage and retract a body organ while allowing for removal of theapplicator instrument from the incision or access port during thesurgical procedure so as to limit the number of incisions or accessports required.

SUMMARY

There is provided a deployable jaws retraction device having a jawassembly including a first flexible jaw having a first distal end and afirst proximal end and a second flexible jaw having a second distal endand a second proximal end. The first proximal end of the first jaw isconnected to the second proximal end of the second jaw at a junction.The jaw assembly additionally includes a retainer engageable with thefirst and second flexible jaws. The first flexible jaw and the secondflexible jaw are movable between a closed constrained condition and anopen unconstrained condition.

The retainer is an O-ring positionable over the first and secondflexible jaws to maintain the first and second flexible jaws in theclosed constrained condition. The first flexible jaw and the secondflexible jaw each include a recess for receipt of the O-ring.

In a specific embodiment, the deployable jaws retraction device furtherincludes a third flexible jaw having a third proximal end and a thirddistal end. The third proximal end of the third flexible jaw isconnected to the first and second proximal ends of the first and secondflexible jaws at the junction. The third flexible jaw also includes arecess for receipt of the O-ring. In a more specific embodiment, thefirst proximal end, the second proximal end and the third proximal endare spaced apart 120° at the junction. In a particular embodiment, thefirst flexible jaw, the second flexible jaw and the third flexible jaweach have an arcuate configuration.

The deployable jaws retraction device further includes an anchorassembly for securing the retraction device away from an operative site.The anchor assembly includes a surgical needle having a tissuepenetrating tip. The anchor assembly further includes a length of suturematerial connecting the surgical needle to the jaw assembly. The lengthof suture material is connected to the jaw assembly at the junction.

There is also disclosed a surgical retraction assembly having adeployable retraction device including a pair of jaws engageable with atarget body organ and a retainer maintaining the pair of jaws inengagement with the target body organ. The surgical retraction assemblyadditionally includes an applicator instrument for insertion of thedeployable retraction device through a body wall and position thedeployable retraction device about the target body organ.

The applicator instrument includes an inner tube for receipt of thedeployable retraction device and a pusher engageable with the deployableretraction device and movable through the inner tube to eject thedeployable retraction device from the inner tube. The applicatorinstrument also includes an outer tube surrounding the inner tube anddefining a space between the inner and outer tubes. The inner tube andthe outer tube are connected together at an end cap.

The retainer is positioned within the space located between the innerand outer tubes. An ejection device is provided within the applicatorinstrument and is movable within the space and engageable with theretainer to drive the retainer over the pair of jaws to maintain thejaws in a closed condition about the target body organ.

In a specific embodiment, the ejection device includes at least one ringrod movable within the space and engageable with the retainer.

In an alternative embodiment, the ejection device includes an ejectiontube movable within the space and engageable with the retainer.

There is further disclosed a method of retracting a target body organaway from an operative site. The method includes providing a deployablejaws retraction device having a jaw assembly including a first flexiblejaw and a second flexible jaw secured together at respective proximalends and a retainer engageable with the first flexible jaw and thesecond flexible jaw to maintain the first and second flexible jaws in aclosed condition about the target body organ.

In the disclosed method, the deployable jaws retraction device ispositioned within an applicator instrument in a closed constrainedcondition and the applicator instrument is inserted into the body of apatient such that the deployable jaws retraction device is positionedadjacent the target body organ. The deployable jaws retraction device isadvanced out of the applicator instrument such that the deployable jawsretraction device expands from the closed constrained condition to anopen condition.

The first flexible jaw and the second flexible jaw of the deployablejaws retraction device are positioned about the target body organ andthe first flexible jaw and the second flexible jaw are moved to theclosed constrained condition about the target organ by advancing aretainer over the first flexible jaw in the second flexible jaw.

DESCRIPTION OF THE DRAWINGS

An embodiment of the presently disclosed deployable jaws retractiondevice and applicator instrument is disclosed herein with reference tothe drawings, wherein:

FIG. 1 is a perspective view of a deployable jaws retraction deviceengaging a body organ and retracting the organ adjacent an abdominalwall;

FIG. 2 is a perspective view of an applicator instrument for positioningthe deployable jaws retraction device about the body organ;

FIG. 3 is a another perspective view of the applicator instrument;

FIG. 4 is a perspective view, partially shown in section, of the distalend of the applicator instrument;

FIG. 5 is a perspective view, partially shown in section, of theapplicator instrument illustrating movement of a retention ring out ofthe applicator instrument;

FIG. 6 is a perspective view, partially shown in section, illustratingthe initial advancement of the deployable jaws retention device toward abody organ;

FIG. 7 is a perspective view, partially shown in section, illustratingthe positioning of a jaw assembly of the deployable jaws retentiondevice about the body organ;

FIG. 8 is a perspective view, partially shown in section, illustratingthe advancement of the retention ring about the jaw assembly; and

FIG. 9 is a perspective view, partially shown in section, illustratingthe engagement of the deployable jaws retention device with the bodyorgan.

DETAILED DESCRIPTION OF EMBODIMENTS

An embodiment of the presently disclosed deployable jaws retractiondevice assembly will now be described in detail with reference to thedrawings wherein like numerals designate identical or correspondingelements in each of the several views. As is common in the art, the term‘proximal” refers to that part or component closer to the user oroperator, i.e. surgeon or physician, while the term “distal” refers tothat part or component further away from the user.

Referring initially to FIG. 1, there is disclosed a deployable jawsretraction device or retraction device 10 which generally includes a jawassembly 12 and an anchoring assembly 14 affixed to jaw assembly 12. Jawassembly 12 is provided to engage and retract a body organ such as bodyorgan B and anchoring assembly 14 is provided to retract body organ Band retain body organ B away from an operative site adjacent analternative body structures such as, for example, abdominal wall AW.

Jaw assembly 12 includes a first jaw 16, a second jaw 18 and third jaw20. First jaw 16 includes a first proximal end 22 and second jaw 18includes a second proximal end 24. First proximal end 22 of first jaw 16is connected to second proximal end 24 of second jaw 18. Third jaw 20additionally includes a third proximal end 26 which is also connected tofirst proximal end 22 of first jaw 16 and second proximal end 24 ofsecond jaw 18. First jaw 16, second jaw 18 and third jaw 20 includerespective first distal end 28, second distal end 30 and third distalend 32.

Jaw assembly 12 is provided to initially be restrained within a surgicalinstrument, described in more detail hereinbelow, in a stressedcondition and deployed outside of the surgical instrument to inunstressed condition for surrounding and engaging body organ B. Firstjaw 16, second jaw 18 and third jaw of 20 are formed in an arcuate shapeor configuration so as to surround the body organ B. It should be notedthat, two of the jaws such as, for example, first jaw 16 and third jaw20 may be formed integrally from a single length of material and thelast jaw such as, for example, second jaw 18 affixed to first jaw 16 andthird jaw 20.

First jaw 16, second jaw 18 and third jaw 20 are formed from a flexiblematerial to allow them to move from a stressed or constrained conditionwhen positioned within the surgical instrument to an open unstressed orunconstrained condition when deployed from the surgical instrument. Thedisclosed flexible materials may include various compatible materialssuch as, for example, spring steels, shape memory alloys, plastics orpolymers, etc.

Jaw assembly 12 additionally includes a retention device such as, forexample, O-ring 34 which is engageable with and positionable over firstjaw 16, second jaw 18 and third jaw 20 to maintain the jaws in a closedposition about the body organ B.

As noted hereinabove, retraction device 10 additionally includes ananchoring assembly 14 for securing jaw assembly 12 and an associatedbody organ BO adjacent an abdominal wall AW. Anchoring assembly 14generally includes a surgical needle 36 having a length of suturematerial 38 affixed to surgical needle 36. Surgical needle 36 includes atissue penetrating tip 40 for piercing abdominal wall AW. A tag end 42of surgical needle 36 is connected to a first end 44 of length of suturematerial 38. A second end 46 of length of suture material 38 isconnected to a junction 48 formed by the connection of first proximalend 22, second proximal end 24 and third proximal end 26 of respectivefirst jaw 16, second jaw 18 and third jaw 20.

It should be noted that, first proximal end 22, second proximal end 24and third proximal end 26 are spaced apart 120° from each other atjunction 48 to allow first jaw 16, second jaw 18 and third jaw 20 toevenly surround and grasp body organ B.

As noted hereinabove, tissue penetrating tip 40 is provided to pierceabdominal wall AW allowing surgical needle 36 to pass through abdominalwall AW. Drawing surgical needle 40 through abdominal wall AW also drawslength of suture material 38 through abdominal wall AW such the jawassembly 12, having body organ BO engaged by jaw assembly 12, is drawntoward or retracted against abdominal wall AW.

Referring now to FIGS. 2-5, and initially with regard to FIGS. 2 and 3,there is disclosed an applicator instrument 50 for retaining retractiondevice 10 during insertion through the abdominal wall AW and deployingretraction device 10 about body organ B. Applicator instrument 50includes an outer tube 52 having an open distal end 54 and a closedproximal end 56 including an end cap 58. A pusher 60 is provided to theeject retraction device 10 from applicator instrument 50 and includes apush rod 62, extending through end cap 58, and a handle ring 64 locatedat a proximal end 66 of push rod 62. First and second ring rods 68 and70, respectively, also extend through end cap 58 and are provided todrive O-ring 34 out of applicator instrument 50 and over first jaw 16,second jaw 18 and third jaw 20 to secure the jaws about body organ B.

Referring now to FIGS. 4 and 5, and as noted hereinabove, pusher 60, andspecifically push rod 62, is provided to eject first jaw 16, second jaw18 and third jaw 20 out of applicator instrument 50 so as to bepositioned about a body organ B. Specifically, a distal end 72 of pushrod 62 is provided to engage junction 48 of first, second, and thirdjaws 16, 18 and 20 respectively (FIG. 4).

Applicator instrument 50 additionally includes an inner tube 74 havingan open distal end 76. A proximal end (not shown) of inner tube 74 isaffixed to end cap 58. As shown, first and second ring rods 68 and 70extend through a space 78 formed between inner tubes 74 and outer tube52. As best seen in FIG. 4, O-ring 34 is initially retained within space78 and adjacent a distal end 80 of first ring rods 68 and a distal and82 of second ring rods 70. Thus, movement of first and second ring rods68 and 70 through space 78 forces O-ring 34 out of space 78 to bepositioned over first jaw 16, second jaw 18 and third jaw 20.

Referring for the moment to FIG. 4, in order to maintain O-ring 34 inengagement with first jaw 16, second jaw 18 and third jaw 20, first jaw16 includes a first recess 84 located between first distal end 28 andjunction 48 and second jaw 18 includes a second recess 86 locatedbetween second distal end 30 and junction 48. Similarly, third jaw 20includes a recess 88 located between third distal end 32 and junction48. Recesses 84, 86 and 88 are provided to receive O-ring 34 and retainO-ring 34 on first jaw 16, second jaw 18 and third jaw 20 so as tomaintain the jaws in the closed position.

Referring now to FIGS. 2, 4 and 6-9, the use of applicator instrument 50to deploy retraction device 10 about body organ B will now be described.Initially, with regard to FIG. 4, retraction device 10 is positionedwithin a bore 90 of inner tube 74. First jaw 16, second jaw 18 and thirdjaw 20 are in a constrained condition within bore 90. As notedhereinabove, junction 48 is positioned adjacent distal end 72 of pushrod 62. O-ring 34 is located within space 78 and adjacent distal ends 80and 82 of first and second ring rods 68 and 70.

In use, while not specifically shown, applicator instrument 50,containing retraction device 10, is inserted through an incision oraccess port formed in an abdominal wall. Applicator instrument 50 ismanipulated to position retraction device 10 adjacent a body organ B.Referring now to FIGS. 2 and 6, once applicator instrument 50 has beenproperly positioned relative to body organ B, handle ring 64 of pusher60 is advanced through end cap 58 (FIG. 2) thereby driving pushrod 62distally through bore 90 of inner tube 74. As pushrod 62 moves distallythroughbore 90, distal end 72 of pushrod 62 engages junction 48 to drivefirst jaw 16, second jaw 18 and third jaw 20 out of bore 90. Uponexiting bore 90, first jaw 16, second jaw 18 and third jaw 20 move orflex outwardly from the constrained condition to an expanded conditionsuch that distal ends 28, 30 and 32 of first jaw 16, second jaw 18 andthird jaw 20, respectively, are sufficiently spaced apart to surroundthe target body organ B.

Referring now to FIG. 7, pushrod 62 continues to be advanced throughapplicator instrument 50 to position first jaw 16, second jaw 18 andthird jaw 20 about body organ B. With reference to FIG. 8, thereafter,ring rods 68 and 70 are advanced distally to drive O-ring 34 out ofspace 78 between outer tube 52 and inner tube 74. O-ring 34 continues tobe advanced distally over first jaw 16, second jaw 18 and third jaw 20forcing the jaws to move together so as to capture body organ B. O-ring34 is advanced a sufficient distal distance so as to be positionedwithin recesses 84, 86 and 88 in first jaw 16, second jaw 18 and thirdjaw 20, respectively, so as to secure the jaws about body organ B (seeFIG. 9).

Thereafter, applicator instrument 50 can be removed back through theincision or access port to free up the incision or access port forinsertion of a subsequent surgical instrument. Referring for the momentback to FIG. 1, surgical needle 36 is manipulated to drive tissuepenetrating tip 40 through abdominal wall AW. Surgical needle 36 isdrawn through abdominal wall AW pulling length of suture material 38,and thus jaw assembly 12 including body organ B, adjacent abdominal wallAW and away from the operative site. In this manner, applicatorinstrument 50 along with retraction device 10 allow body organ B to beretracted away from the operative site without the need for anadditional surgical incision or access port.

It will be understood that various modifications may be made to theembodiments disclosed herein. For example, the disclose jaw assembly mayinclude more or less than three jaws. Further, alternative retentiondevices may be provided to secure the jaws in a closed condition suchas, for example, clips, lengths of suture, tubular shields, etc.Additionally, the disclosed applicator instrument may include othermethods of anchoring the disclose jaw of assembly to an abdominal wallsuch as, for example, staples, barbed tacks, etc. Therefore, the abovedescription should not be construed as limiting, but merely asexemplifications of particular embodiments. Those skilled in the artwill envision other modifications within the scope and spirit of theclaims appended hereto.

1. A method for retracting target tissue from an operative sitecomprising: inserting an applicator including a jaw retraction devicethrough an incision on a patient; advancing a jaw assembly includingfirst and second flexible jaw members from the applicator forpositioning target tissue between the first and second flexible jaws,the first and second flexible jaw members secured together at a junctionat a proximal end of the jaw assembly; advancing a retainer from theapplicator to engage the first and second flexible jaw members formoving the first and second jaws to a clamping configuration; andmanipulating a needle including a suture coupled thereto and to thejunction of the jaw assembly though the incision on a patient to removethe target tissue.
 2. The method according to claim 1, includingproviding the first and second flexible jaw members with an arcuateconfiguration.
 3. The method according to claim 1, including utilizingan O-ring for the retainer, the O-ring being positionable over the firstand second flexible jaw members.
 4. The method according to claim 3,including providing the O-ring on a pair of ring rods that aretranslatable through the applicator, wherein the O-ring is releasablycoupled to the pair of ring rods.
 5. The method according to claim 3,wherein advancing the retainer further includes advancing the O-ringinto recesses that are formed on the first and second flexible jawmembers.
 6. The method according to claim 1, including providing the jawassembly on a push-rod that is translatable through the applicator,wherein the jaw assembly is releasably coupled to the push-rod.
 7. Themethod according to claim 1, further including providing a thirdflexible jaw member that is connected to the first and second flexiblejaw members at the junction.
 8. The method according to claim 7,including providing a recess on the third flexible jaw member.
 9. Themethod according to claim 7, further including spacing the first, secondand third flexible jaw members 120° apart from one another.